OVERSEE-II: Potential Improvements in Acute Cancer Care According to Clinical Staff in the Emergency Department Care
Study Details
Study Description
Brief Summary
The goal of this Single center prospective cross-sectional study is to identify the facilitators and barriers among caregivers in the emergency department that influence disposition of patients with solid and hematology malignancies. The main question it aims to answer is what the agreement between the emergency department (ED) caregivers predicted outcome and the actual outcome is. Participants will be asked for permission, afterwards a short interview will be held with the different ED caregivers (ED nurse, attending physician and supervising physician).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
The goal of this to identify the facilitators and barriers among caregivers in the emergency department (ED) that influence disposition of patients with solid and hematology malignancies. The main question it aims to answer is: what is the agreement between the ED caregivers predicted outcome and the actual outcome. Participants will be asked for permission, afterwards a short interview will be held with the different caregivers (ED nurse, attending physician and supervising physician) in the ED. The interviews will be held in the order of the ED care pathway, meaning ED nurse first, treating physician second and supervising physician at last. The interviews will be conducted for every patient with each of the caregivers. Each interview will be conducted after the caregiver has made the first examination of the patient. The interview focuses on several parts of the emergency care process: The first part is regarding the actions that are executed during an ED visit. It will be established, which actions are executed and why. The second part are regarding the suspected outcome for the patient. The third part will be about any potential improvements on de emergency care process for the patient.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Cancer patients All adult patients with solid and hematologic malignancies and receiving systemic therapy admitted to the emergency department of the Erasmus Medical Center (MC) for the oncology, hematology, lung- and neuro-oncology medical unit. |
Behavioral: Emergency department caregivers interview
The interview focuses on several parts of the emergency care process: The first part is regarding the actions that are executed during an emergency department visit. The investigators will establish, which actions are executed and why. The second part are regarding the suspected outcome for the patient. The third part will be about any potential improvements on de emergency care process for the patient.
|
Outcome Measures
Primary Outcome Measures
- Emergency department (ED) length of stay (LOS) [Through study completion, an average of 6 months]
Emergency department length of stay
- Disposition [Through study completion, an average of 6 months]
Outcome after ED admission, being home or admission
- Correlation between ED-LOS and disposition [Through study completion, an average of 6 months]
Correlation between ED-LOS and disposition
- ED nurse agreement of disposition [Through study completion, an average of 6 months]
Agreement between ED nurse expected disposition and the actual disposition
- Attending physician agreement of disposition [Through study completion, an average of 6 months]
Agreement between treating physician expected disposition and the actual disposition
- Supervising physician agreement of disposition [Through study completion, an average of 6 months]
Agreement between supervising physician expected disposition and the actual disposition
Secondary Outcome Measures
- Time-to-disposition [Through study completion, an average of 6 months]
The time between patient's arrival at the ED and the decision to disposition
- Time-to-ward [Through study completion, an average of 6 months]
The time between the decision to hospitalize and the arrival at the ward
- Correlation between time-to-disposition and the ED-LOS [Through study completion, an average of 6 months]
Correlation between time-to-disposition and the ED-LOS
- Correlation between time-to-ward and the ED-LOS [Through study completion, an average of 6 months]
Correlation between time-to-ward and the ED-LOS
- ED nurse identified categories of facilitator and barriers [Through study completion, an average of 6 months]
Categories of facilitator and barriers identified by the ED nurse for the ED care of patients with cancer
- Attending physician identified categories of facilitator and barriers [Through study completion, an average of 6 months]
Categories of facilitator and barriers identified by the attending physician for the ED care of patients with cancer.
- Supervising physician identified categories of facilitator and barriers [Through study completion, an average of 6 months]
Categories of facilitator and barriers identified by the supervising physician for the ED care of patients with cancer.
- Difference in categories [Through study completion, an average of 6 months]
The difference in the percentages in categories between the different caregivers
- ED nurse summary of actions [Through study completion, an average of 6 months]
Summary of actions taken by ED nurse in the ED care for patients with cancer
- Attending physician summary of actions [Through study completion, an average of 6 months]
Summary of actions taken by attending physician in the ED care for patients with cancer
- Supervising physician summary of actions [Through study completion, an average of 6 months]
Summary of actions taken by supervising physician in the ED care for patients with cancer
Other Outcome Measures
- Patient characteristics [Through study completion, an average of 6 months]
age, sex, type of cancer, type of treatment, main complaint, triage category, number of prior ED visits.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
- Patients with solid and/or hematology malignancies and receiving system therapy
-
Presented at the emergency department or admitted from the emergency department (ED) to the oncology, hematology or lung-oncology clinical unit
-
Awake and conscious
-
Possible to answer questions within 48 hours after presentation in the ED
Exclusion Criteria:
-
<18 years old
-
Primarily received a surgical intervention as treatment
-
Admitted to the ED for the surgical department
-
Not willing or able to give written informed consent
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Erasmus Medical Center
Investigators
- Principal Investigator: Jason den Duijn, Erasmus Medical Center
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 10842